Nokea
The nurse is monitoring a patient who is taking a potassium-sparing diuretic. Which of the drugs or drug classes may have an interaction with this type of diuretic?
- A. Lithium
- B. Vancomycin
- C. Potassium supplements
- D. NSAIDs
- E. Antidiabetic drugs
- F. ACE Inhibitors
Correct Answer: A,C,D,F
Rationale: Taking lithium with potassium-sparing diuretics may cause lithium toxicity; taking ACE inhibitors or potassium supplements may lead to hyperkalemia. Taking NSAIDs with potassium-sparing diuretics may cause a decreased diuretic response. There are no interactions with vancomycin or antidiabetic drugs and potassium-sparing diuretics.
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A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?
- A. Loop diuretics
- B. Osmotic diuretics
- C. Thiazide diuretics
- D. Potassium-sparing diuretics
Correct Answer: C
Rationale: The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8) guidelines reaffirmed the role of thiazide diuretics as among the first-line drugs in the treatment of hypertension. The other drug classes are not considered first-line treatments.
A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?
- A. Loop diuretics
- B. Osmotic diuretics
- C. Thiazide diuretics
- D. Vasodilators
Correct Answer: B
Rationale: Mannitol, an osmotic diuretic, is commonly used to reduce intracranial pressure and cerebral edema resulting from head trauma.
When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include what symptoms?
- A. Dyspnea
- B. Constipation
- C. Tinnitus
- D. Muscle weakness
- E. Anorexia
- F. Lethargy
Correct Answer: D,E,F
Rationale: Symptoms of hypokalemia include anorexia, nausea, lethargy, muscle weakness, mental confusion, and hypotension. The other symptoms are not associated with hypokalemia.
Furosemide is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
- A. Take this medication in the evening.
- B. Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates.
- C. If you experience weight gain, such as 5 pounds or more per week, be sure to tell your physician during your next routine visit.
- D. Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.
Correct Answer: D
Rationale: Orthostatic hypotension is a possible problem with diuretic therapy. Foods high in potassium should be eaten more often, and the drug needs to be taken in the morning so that the diuretic effects do not interfere with sleep. A weight gain of 5 pounds or more per week must be reported immediately.
A patient is to receive furosemide (Lasix) via a percutaneous endoscopic gastrostomy (PEG) tube. The order reads, "Give furosemide, 60 mg, per PEG tube once daily. The medication is available in a liquid form, 40 mg/5 mL. Identify how many milliliters the nurse will administer for each dose.
Correct Answer: 7.5 mL
Rationale: 40 mg : 5 mL :: 60 mg : x mL; (40 * x) = (5 * 60); 40x = 300; x = 300/40 = 7.5 mL.